Childbirth Education

A healing mission: Doctors perform 22 surgeries in 3 days in Indian village

Drs. Laura and Lane Smothers perform a hysterectomy at Sharon Hospital in Salem, India, as anesthesiologist Dr. John Billings assists and orthopedic surgeon Dr. Steven Orcutt observes.
The Wyoming Medical Center doctors performed 22 surgeries in three days as part of a mission trip with Highland Park Community Church in Casper. Highland Park has adopted the nearby village of Nachinampatty on a five-year program to address issues such as childcare, education, skills development, hygiene, immunization, church planting and more, said team leader Vicki Orcutt. This mission included the first medical team. After its success, another medical team will likely return next year.

Of all the patients he and his fellow doctors healed during their mission trip to India, Dr. Steven Orcutt remembers the one he didn't treat: A boy with fused fingers.

Orcutt was one of four WMC doctors who returned Aug. 1 from the medical mission. He, Drs. Laura and Lane Smothers and Dr. John Billings performed 22 surgeries in three days in Salem, India, on patients who would otherwise never be able to afford to see a doctor. They were part of Highland Park Community Church’s larger mission team who traveled to the church’s adopted village of Nachinampatty .

The volume of surgeries wasn't so big of deal, said Orcutt, an orthopedic hand surgeon with Casper Orthopaedic Associates and Wyoming Medical Center. It’s not much more than the volume the doctors would do in their own practices over three days. What was the different were the conditions under which those surgeries were performed.

“There wasn’t a day in the OR that the lights didn’t go out. We just had to wait in the dark until they came back on,” Orcutt said. “We have everything we need here. In India, they have to make do.”

The instruments they used would have been typical of an American operating room from the 1950s or ‘60s. Doctors operated on two patients in the same room, side by side.

There were other differences too. Discover some in the photos below. Scroll all the way through for mission insights from the doctors and premed students Micah Scaling and Kate Birkett.

This was the first medical team Highland Park has sent to India. The team is already planning another trip in 2014, this time for two weeks.

Perhaps it has a little to do with the boy with fused fingers. The orphan was Birkett’s sponsor child, meaning she pays $30 a month to make sure he is fed, clothed and educated. She got to meet him on the trip and Orcutt, a hand surgeon, got a close look at the boy’s fingers, webbed together like a flipper.

“It’s ok,” Orcutt said to his colleagues as they prepared to leave. “We’re coming back next year.”

These are the general living conditions of many villages in rural India where 750 families may share one “sanitary station,” or toilet, mission team leader Vicki Orcutt said.
Highland Park Community Church sponsors the village of Nachinampatty through the India Gospel League, a nonprofit group working to eradicate poverty and social injustices while bringing the message of Christ. On this mission, the team stayed at Sharon Gardens which has an orphanage, a school, and a hospital and oncology center on campus.
“They have 200 orphans that they feed and send to school. You feel glad that there is somebody there to take care of them, otherwise they’d be on the sidewalk,” said Steven Orcutt, an orthopedic hand surgeon with Casper Orthopaedic Associates and Wyoming Medical Center. “The only way they are going to fix poverty in India is through education.”

Orphans from Sharon Gardens mob Micah Scaling, a premed student who worked as a WMC phlebotomist this summer.
“The children love visitors from America, especially younger ones,” Vicki Orcutt said.
The Sharon Gardens campus is home to the CEO of India Gospel League, Sam Stephens and his wife Prati. The campus houses the Sharon Hospital and a nursing school, a children's home and school, the Thomas Chapel and training centers in tailoring, livestock and brick making.

Children from Sharon Gardens smile for the camera.
Besides the medical clinics in a nearby village, the mission team spent time with the children, even helping them to plant a vegetable garden. Seeing the work of India Gospel League President Samuel Stephens and his family was inspiring, Micah Scaling said.
“He (and his family) were so significant to me during this trip because of how efficiently and successfully they have run their organization and by the countless number of lives that they have changed and continue to change. The Stephens family has answered God's call on their lives, and the fruits of their labor and perseverance are evident in the exponential growth of their work.”

Nursing student Lexi Billings takes patients’ vital signs before they see the doctors. Many of the families traveled hours by foot, bus or bike for medical care they likely otherwise would never be able to afford.
The family of one 2 ½-year-old boy came 11 hours by bus and motorcycle just on the chance that Dr. Steven Orcutt could correct the boy’s club foot.
“The average person makes $2 a day in the villages. If you wanted to go see a doctor, it’d probably cost $5 or $6,” he said. “The operation on the boy’s foot would have cost $300 to $400. There’s no possible chance that the family could have afforded it at all.”
The surgery ultimately took 45 minutes and was successful. Though the child will probably need some corrective footwear, he will be able to walk normally.

Dr. Laura Smothers, a gynecologist at Womens’ Health Associates and Wyoming Medical Center, listens to a patient describe her ailments via a translator before the surgical clinics. Language was an early barrier, and even the translators spoke in accents the doctors sometimes couldn't understand. The team relied on gestures and facial expressions to facilitate communication.

A mother in Nachinampatty waits for her baby to be examined at the medical camp.
“I cannot fully describe the value that a trip like this can have on an individual,” Micah Scaling said. “The exposure to a different culture and way of life, witnessing firsthand of phenomena like rampant perpetual poverty like we have never imagined, and the opportunity to be involved in bringing about lasting change all make for an unforgettable experience that will last a lifetime and entirely change one's perspective.”

Patients and their families line the right side of the hallway of Sharon Hospital waiting for the doctors to arrive.
“One of the things that impacted me the most was the gratitude of the patients towards us before and after surgery,” said Dr. Laura Smothers.
Patients were scheduled to be at the hospital for a week, during which their surgeries could occur at any time – if they were found to be good surgical candidates. By the time doctors arrived, they and their families had been at the hospital for days, getting preoperative lab and radiology evaluations. Several required pre-op transfusions due to chronic blood loss and poor nutrition, Smothers said.
“Each day, when we arrived and when we departed, these people who had been waiting for days would rise to their feet to greet us and express respect and thanks.”

Dr. Laura Smothers performs a hysterectomy with assistance from Dr. Lane Smothers, a surgeon with Wyoming Surgical Associates and Wyoming Medical Center.
Operating room conditions were very different than in America. For example, nurses in India ventilate patients under anesthesia by hand and almost everything is used and reused. The only trash the doctors threw out were their gloves, the prep sponges and needles.
“At the end of every case in the U.S. we throw away at least one giant biohazard bag full of gowns, drapes, tubing, laparotomy sponges, suction canisters, etc. It was interesting to observe the priority of cost savings there,” Dr. Laura Smothers said. “We take so much for granted here -- the availability of every imaginable instrument or suture, the availability of multiple specialists if needed for a consult, the availability of toilet paper …”
Perhaps the biggest difference, though, was the operating room footwear. The sign on the door read: “Sterile Zone: Please remove your shoes” and rows of flip flops lined the wall. In U.S. operating rooms, closed-toe shoes are mandatory.
“Lane Smothers and I had a deal that I wouldn't drop a scalpel on his foot if he wouldn't drop one on mine,” Dr. Steven Orcutt said.

Drs. Lane Smothers and Steve Orcutt remove benign tumors from two patients in the same operating room, something that would not be done in America.
“Throughout the day, the doctors performed nine surgeries total,” wrote Katelyn Birkett in a blog post she wrote for “Inspiration from India” about the trip.
“Several people had benign tumors removed, a couple women had hysterectomies and a couple people had plates removed from previous surgeries. … The doctors worked very hard, each of them adjusting to many situations,” wrote Birkett, premed student and a certified nurse’s assistant with Wyoming Medical Center.
“Dr. (John) Billings, our anesthesiologist, had to adjust to so many unfamiliar things. The equipment he was using was probably the equipment we were using in the U.S. about 50 years ago. Some medicines were spelled wrong, some were expired and some they just didn’t have. Regardless, by the grace of God and Dr. Billings’ work, he successfully worked with each of the cases today.”

Children lie on beds in the pediatric ward at Sharon Hospital while a nurse looks on.
“An outstanding aspect to me about the hospital was how quiet and peaceful the entire facility was,” Micah Scaling said. “The hospital was run and even built in such a way that there was never any disturbance or constant noise that could interfere with patient comfort. The environment was such that it emulated a home setting for all of their patients, which I felt exemplified a cultural norm of peacefulness.”

Dr. John Billings, in the blue scrubs, oversees anesthesia while orthopedic surgeon Dr. Steven Orcutt removes hardware from a patient’s previously broken leg. Nurses and nursing students who work at Sharon Hospital are in the background observing and assisting.
The majority of the nurses and technicians working at the hospital were raised in the children’s home at Sharon Gardens, Birkett wrote in her blog.

Kate Birkett teaches a child to blow bubbles while in the Sharon Hospital.
Towards the end of the first day of surgery, an Indian doctor asked her the difference between there and the U.S.
“It’s the same, no?” he asked.
“About a million differences ran through my head as I tried to think of something appropriate to say,” Birkett wrote in her blog. “It was then that it hit me. ‘Sterile’ may have a different definition in India, the machines may be far outdated by our standards, and some of the supplies may be expired. But, no matter where you are in the world, a doctor is a doctor. Despite our differences, it is easy to see that by the grace of God, people were healed today. Because it didn’t matter if they were Indian or American. It mattered that they were doctors.”